Kornimate/medical-research-clean huggingface dataset:
perioperative analgesia on postoperative opioid usage and pain control in h&n cancer surgery

Conditions: Postoperative Pain Control; Opioid Consumption

Summary: the purpose of this study is to determine how a non-opioid pain control regimen, administered before and during surgery, will affect postoperative pain control and total opioid consumption in head and neck cancer participants undergoing cancer surgery with free flap reconstruction.

this study will help the study team determine how the experimental, non-opioid pain control regimen affects opioid-related side effects, participant satisfaction with pain management, pacu length of stay, hospital length of stay, chronic pain level, and chronic pain-related disability in participants, and to determine the safety and tolerability of the non-opioid pain control regimen in head and neck cancer patients undergoing cancer surgery with free flap reconstruction. ketamine, lidocaine, acetaminophen, gabapentin, and celecoxib are fda-approved drugs that have been approved for use individually, and have been used in combination for perioperative pain control. however, the use of these five drugs together in head and neck cancer patients undergoing free flap reconstruction has not been studied, which is why this study is experimental.

Eligibility criteria:
inclusion criteria: * undergoing head \& neck free flap reconstruction at the cleveland clinic main campus * subjects must have the ability to understand and the willingness to sign a written informed consent document. exclusion criteria: * history of allergy to lidocaine, ketamine, acetaminophen, gabapentin, and/or celecoxib * history of allergic reactions attributed to compounds of similar chemical or biologic composition to ketamine, lidocaine or other agents used in this study * subjects receiving any other investigational agents * inadequate renal function (serum creatinine ≥ 2 mg/dl) within 30 days * inadequate hepatic function (total bilirubin ≥ 2 x the institutional uln and/or ast or alt ≥3 x the institutional uln) within 30 days * known or suspected history of illicit drug abuse (including opioids but excluding tobacco and etoh) within the past 6 months * pregnancy * contraindication to lidocaine (heart block, heart failure with ef \< 30%) as determined by history of congestive heart failure, or as determined by preoperative evaluation for surgical clearance * in the opinion of the investigator, subjects with uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements

Keywords: head & neck cancer microvascular free flap reconstruction
median sevoflurane concentration for hypotension between young and elderlypatients: adaptive clinical trial

Conditions: Hypotension

Summary: two arms: elder group, young group. dixon's up and down adaptive methodology for ed50. executed after anesthesia induction for 10min without touching the patient after starting mechanical ventilation.

this adaptive clinical trial will vary target end tidal sevoflurane by 0.4, then by 0.2 and by 0.1 thereafter in order to minimize sample size.

Eligibility criteria:
inclusion criteria: * understands experiment, is voluntary, signs informed consent; * does not take medication that influences arterial pressure; * normotensive. exclusion criteria: * received any medication that influences arterial pressure before experiment;

Keywords: hypotension sevoflurane elderly
metabolic and cardiovascular effects of dipeptidyl peptidase-4 (dpp-4) or sodium-glucose co-transporter type 2 (sglt2) inhibitors

Conditions: Effects of the DPP-4 Inhibitors or SGLT2 Inhibitors on the Protective Actions for Diabetic Complications

Summary: inhibition of dipeptidyl peptidase-4 (dpp-4) or sodium-glucose co-transporter type 2 (sglt2) has been proposed as a therapeutic target for type 2 diabetes. however, how dpp-4 inhibitors or sglt2 inhibitors exert protective actions for diabetic complications in addition to their glucose-lowering effects remains unknown.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of type 2 diabetic patients * must be able to swallow tablets * never received dpp-4 inhibitors or sglt2 inhibitors exclusion criteria: * uncontrolled diabetes (fasting plasma glucose\>200 mg/dl) * receiving insulin therapy * hepatic disorders (2.5 fold or greater increases in aspartate transaminase or alanine transaminase levels above the upper limits of normal) * inflammatory disorders * neoplastic disorders * recent (\<3months) acute coronary syndrome and stroke * any acute infection
preventing gastric glitch with prucalopride and buspirone: n-of-1 clinical trial

Conditions: Dyspepsia

Summary: background: gastric glitch is a new functional disease characterized by severe and transient epigastric pain occurring after challenges such as drinking alcohol and eating specific foods. aims: in this n-of-1 trial, we first characterized the clinical and gastric tomographic images of a patient with gastric glitch highly reproducible after alcohol challenging, and then tested the effect of prucalopride and buspirone on the prevention of gastric glitch crises.

objective: to evaluate the effect of prucalopride and buspirone, compared to placebo, in the prevention of gastric pain crises, in a double-blind clinical trial of a single patient. methods: female, 35 years old, with signed consent to participate in the study, received 15 capsules to take 1 capsule 60 minutes before ingesting 200 ml of red wine at home (≈20 grams of alcohol), twice a week, according to her routine food, totaling 15 meals. thus, the experimental phase lasted about eight weeks. the 15 capsules contain placebo (5 capsules), prucalopride 2 mg (5 capsules) or buspirone 10 mg (5 capsules), prepared by a specialized pharmacy in such a way that their physical characteristics do not allow the identification of which agent is being administered, neither by the patient nor the investigator controlling the trial (double-blind). the aforementioned pharmacy generated a code for each pill, randomly, and provided a sealed list with the 15 codes and their respective drugs, for disclosure after the end of the study. the patient was instructed to record in a standardized diary the occurrence of pain crises after the wine challenge, as well as their duration and intensity (likert 0 to 10: maximum pain), and accompanying symptoms. the patient was asked to contact the researchers directly (whatsapp) throughout the trial, to clarify any doubts or need for some assistance due to the occurrence of symptoms related to the study. the study statistics will be descriptive in terms of pain events, and the effect of the drugs will be evaluated in a statistical model suitable for the n-of-1 trial. prucalopride is a 5-ht4 receptor agonist that accelerates gastric emptying, while buspirone is a 5-ht1a receptor agonist that enhances gastric accommodation function. the presumed pathophysiology underlying the patient's pain is retention of wine in the gastric lumen, causing pain. stimulating gastric emptying with prucalopride or increasing the accommodation of the gastric fundus with buspirone could prevent or alleviate the pain crisis.

Eligibility criteria:
inclusion criteria: * adult patient suffering from severe gastric pain after ingestion of a small amount of wine exclusion criteria: * n/a (n-of-1 trial)
platelet inhibition in the acute phase of stemi

Conditions: Acute Myocardial Infarction; Antiplatelet Therapy; ST-segment Elevation Myocardial Infarction (STEMI)

Summary: background: dual antithrombotic treatment with aspirin and clopidogrel is recommended in patients with st elevation myocardial infarction (stemi) undergoing primary percutaneous coronary intervention (pci). the european society of cardiology (esc) guidelines recommend a bolus dose of aspirin of 250-500 mg and a 600 mg bolus dose of clopidogrel as soon as stemi is suspected. studies have shown that more newly produced platelets are present in the acute phase of stemi, and it is likely that these immature platelets are haemostatically more active and might be of importance in thrombus formation. the enhanced platelet reactivity may reduce the effect of aspirin and clopidogrel in the acute phase of stemi compared to measurements made in the same patients 3 months after primary pci. aim: this study aims to compare platelet response to aspirin and clopidogrel in the acute phase of stemi with the platelet response in the same patients 3 months after stemi . design: this study is an observational follow-up study. materials and methods: 46 patients with stemi referred to primary pci at aarhus university hospital, skejby will be included in the study. a total of 3 blood samples are obtained in the acute phase of stemi: prior to primary pci (blood sample 1), at 4 hours (blood sample 2) and at 12 hours (blood sample 3) after administration of loading dose aspirin and clopidogrel. when patients are in a stable phase 3 month later, a final blood sample is taken (blood sample 4). the blood is analyzed 30 minutes after withdrawal of blood by the platelet aggregation test multiplate® aggregometry (agonists: collagen, arachidonic acid and adenosinediphosphate) and verifynow® arachidonic acid and p2y12 aggregometry. platelet count, volume and the immature platelet fraction (ipf) will be measured using sysmex® flowcytometry.


Eligibility criteria:
inclusion criteria: * above 18 years of age * patients with st-segment elevation myocardial infarction (stemi) referred to primary pci at university hospital of aarhus, skejby. exclusion criteria: * treatment with nsaid, ticlopidine and dipyramidole. * treatment with anticoagulants (vitamin k antagonists) * patients diagnosed with platelet disease or haemophilia. * patients unable to give written, informed consent to participation in this project.

Keywords: stemi acute myocardial infarction antiplatelet therapy aspirin clopidogrel verifynow aggregometry multiplate aggregometry
feasibility of dpp-4 inhibitor therapy on advanced hybrid closed loop system

Conditions: Time in Range

Summary: background: ramadan iftar meal typically causes glucose excursions. dipeptidyl peptidase-4 inhibitors increase serum concentrations of glucagon-like peptide-1 and thus, decrease blood glucose levels with low risk of hypoglycemia. aim: to investigate the efficacy and safety of vildagliptin as an add-on therapy among adolescents and young adults with type 1 diabetes mellitus (t1dm) on glucose excursions of iftar ramadan meals and glycemic metrics during advanced hybrid closed-loop (ahcl) treatment.

current management of people with type 1 diabetes mellitus (t1dm) on intensive insulin therapy recognizes carbohydrates as the most important determinant of postprandial glycaemia; hence, worldwide guidelines recommend carbohydrates counting for determining pre-prandial insulin doses. currently, the insulin to carbohydrate ratio (icr) is frequently used to calculate the meal insulin dose. however, icrs are considered difficult, ineffective and inaccurate for some patient, with an estimation error of around 20% in adults demonstrating only modest improvements in glycated hemoglobin (hba1c). this lack of effectiveness and the wide variability using icrs suggests it should be improved upon. however, there have been only a few randomized control studies that investigated the efficacy and safety of dpp-4 inhibitors as an add-on drug in patients treated with basal insulin. therefore, we conducted a one-month randomized control trial to investigate the efficacy and safety of dpp-4 inhibitors as an add-on therapy among adolescents and young adults with t1dm on glucose excursions of iftar ramadan meals and glucometrics during ahcl treatment .

Eligibility criteria:
inclusion criteria: * patients with type 1 diabetes (t1dm )for at least one year * patients aged 12-27 years * patients using minimed 780g ahcl system (medtronic, northridge, ca, usa) at least 6 months before the study * patients with minimum daily insulin requirement of more than 8 units * patients willingness and ability to adhere to the study protocol, access to the internet and a computer system that met requirements for uploading the study pump data. exclusion criteria: * patients with any microvascular or macrovascular complications * pregnancy, lactation * patients who had a point-of-care screening hba1c \>10.0% (86 mmol/mol) * patients with hypoglycemic unawareness or recurrent severe hypoglycemic episode in the last 6 months prior to recruitment * patients with recurrent dka (more than 2 episodes in the previous 6 months). * patients with any chronic medical condition, current use of medications (other than insulin) that are known to affect blood glucose level. * patients who had prior adverse reactions to the adjunctive agent
randomized study for effectiveness and safety evaluation of dexamethasone 0.5 mg + fumarate clemastine 1 mg compared to dexamethasone 0.5 mg in patients with allergic dermatitis

Conditions: Allergy; Dermatitis

Summary: the aim of this study is to prove the efficacy of the dexamethasone 0.5 mg + 1 mg clemastine fumarate tablet compared to 0.5 mg of dexamethasone in reducing the signs and symptoms of allergic dermatitis.


Eligibility criteria:
inclusion criteria: * patients who sign the ic in two ways, agreeing with all study procedures * patients aged above 18 years of any ethnicity, class or social group, female or male * patients with acute, subacute or chronic dermatoses, of inflammatory and / or allergic origin, to which it is recommended the use of drugs under investigation, such as: * atopic dermatitis * prurigo * primary contact dermatitis or allergic hives * drug eruption * allergic vasculitis * dyshidrosis, note: the above clinical conditions are diagnosed from clinical examination. exclusion criteria: * patients being treated with antibiotics * participation in clinical trials in the 12 months preceding the investigation * current treatment with immunosuppressants (eg, cyclosporine or methotrexate) * current treatment with phototherapy (uva, uvb, puva and lasers) * use of systemic corticosteroids in the visit to include or 15 days preceding the survey * topical treatments at the site of lesions in the 15 days preceding the survey * presence of any skin condition * presence of secondary infections at the site of treatment, diagnosed clinically; * presence of other eczematous diseases, such as nummular eczema, neurodermatitis, seborrheic dermatitis, psoriasis, scabies, and buckley's syndrome * pregnant or lactating women * chronic alcoholism * patients with a history of hypersensitivity to any component of the products under investigation. * any finding of clinical observation (clinical history or physical examination) that is interpreted by the physician investigator as a risk to the patient's participation in the study. * allergic dermatosis mild or, acording to the investigator criteria, is not justified systemic treatment.

Keywords: allergic dermatitis
viral respiratory and gastrointestinal infections in children under 6 years of age

Conditions: Bronchiolitis; Gastroenteritis; Convulsion, Febrile

Summary: with the use of molecular methods new viruses have been detected in respiratory and gastrointestinal tracts of both patients and asymptomatic subjects in recent years. the clinical importance of these viruses has not been adequately studied. the aim of this study is to use molecular methods to detect viruses in upper respiratory tract and gastrointestinal tract of children with acute bronchiolitis, acute gastroenteritis and febrile convulsions and to try to correlate the severity of clinical picture with the amount of viruses present in clinical samples. the investigators will also try to detect the increase in specific antibodies in paired sera.


Eligibility criteria:
inclusion criteria: presence of * acute bronchiolitis * acute gastroenteritis * febrile convulsion requiring hospital admission exclusion criteria: * none

Keywords: acute bronchiolitis acute gastroenteritis febrile convulsion viral agents molecular methods
injection site pain botulinum toxin reconstituted in ns with and without sodium bicarbonate

Conditions: Wrinkle

Summary: this study was designed to investigate the effects of botulinum toxin type a injections diluted with the mixture of sodium bicarbonate (sb) and normal saline (ns) on pain reduction, onset of action and duration of action. this is a prospective, randomized, double-blind clinical study, which included 30 female patients (age\>25). the patients were randomized to receive botulinum toxin (bt) injections diluted with ns and sb on one side of the face and saline control injections on the other side. pain severity was assessed using visual analogue scale. the onset and duration of action were recorded according to the patients' subjective opinions after 1 week and 3 months, respectively. the study was approved with an irb (institutional review board) number of rc19/371.


Eligibility criteria:
inclusion criteria: * any female patient who is in good health and has moderate dynamic forehead and glabellar wrinkles. exclusion criteria: * • patients \<25 years old * presence of neuromuscular disease or intake of drugs affecting muscle tone. * any active infection in the treatment area. * patients receiving anticoagulation or had a diagnosis of bleeding disorders. * any patient who had undergone the following treatments to the forehead area in the past 6 months: botulinum toxin injections, ablative laser procedures, radiofrequency device treatments, ultrasound device treatments, or medium to deep chemical peels. * any patient who had temporary soft-tissue augmentation material to the forehead area in the past 12 months, semi permanent soft-tissue augmentation material in the past 2 years, or permanent soft-tissue augmentation material at any point in the past. * any patient with prior facial cosmetic surgical procedures such as eyebrow-lifts, blepharoplasties, and rhytidectomies.
fenoldopam and ketanserin for acute kidney failure prevention after cardiac surgery

Conditions: Acute Renal Failure

Summary: the purpose of the study is to compare the effect of fenoldopam and ketanserin on kidney function preservation in patients at high risk for renal failure after cardiac surgery. acute, oliguric renal failure develops in up to 2% of patients undergoing cardiac surgery. some of them require renal replacement therapy and despite that mortality in this group exceeds 30-60%. the investigators await that the use of fenoldopam and/or ketanserin may decrease the rate of severe renal failure.

informed, signed consent will be obtained from the patient before surgery. in patients with acute consciousness disorders, the consent will be obtained from a legal representative and confirmed by the local court - accordingly to polish legacy. patients willing to participate into the study and fulfilling at least one of two inclusion criteria will be randomly assigned to one of the three study groups. the treatment will be applied for 24 hours. intention to treat analysis will include comparison for differences of continuous, homogeneous distributed data with use of parametric tests, parametric or inhomogeneous distributed data - with use of nonparametric tests. the treatment effect will be assessed by comparison of the odds ratios for primary and secondary outcomes between the groups.

Eligibility criteria:
inclusion criteria: * cardiac surgery * at least one risk factor for acute renal failure: 1. oliguria \< 0.5 ml/kg/hour for over 3 hours despite adequate blood volume and furosemide intravenously 2. at least 60 mg furosemide/12 hours iv to maintain diuresis \> 1 ml/kg/hour exclusion criteria: * refused or none consent * chronic renal failure with chronic renal replacement therapy * chronic increase of serum creatinine \> 2 mg/dl

Keywords: cardiac surgery fenoldopam ketanserin renal replacement therapy
plan to evaluate early endothelialization of a polymer free sirolimus-eluting coronary stent system (vivo isartm) compared with everolimus-eluting durable polymer stent (xience skypointtm) in patients undergoing percutaneous coronary intervention.

Conditions: Coronary Artery Disease

Summary: to evaluate the stent endothelialization (\> 20 microns) of vivo isartm versus xience skypointtm stents at 1-month (very early strut covered) at follow-up by optical coherence tomography (oct) implanted in the same patient during routine clinical practice.

to evaluate the stent endothelialization (\> 20 microns) of vivo isartm versus xience skypointtm stents at 1-month (very early strut covered) at follow-up by optical coherence tomography (oct) implanted in the same patient during routine clinical practice.

Eligibility criteria:
inclusion criteria: * patients with age ≥ 18 years and * patients who have signed informed consent and * patients with coronary artery disease requiring percutaneous treatment with coronary stents due to de novo lesions in vessels with a diameter of reference from 2.25 mm to 4.0 mm and * patients with at least 2 angiographic lesions in 2 different major coronary arteries. or in the main branch and in one of its subsidiaries branches , as long as those are not "downstream" of the lesion from the main branch exclusion criteria: * express refusal of the patient to participate in the study * patients with st elevation myocardial infarction or cardiogenic shock * patients with high thrombotic content * pregnant or breastfeeding patients * patients with complex pci (percutaneous coronary intervention )(defined as): * left main pc * chronic total pc occlusion * bifurcation lesion requiring 2-stent technique . * severe calcified lesion (need to use prior complex techniques of calcium modification such as intravascular lithotripsy, rotational/orbital atherectomy, laser. * patients with malignant neoplasms or other comorbid conditions with life expectancy \<12 months * patients with a target lesion in a bypass graft * lesions due to restenosis * patients with pci in the target vessel in the previous 9 months * patients with contraindication or difficulty to evaluate in the follow-up with oct (renal failure, excessive tortuosity or lesions aorto-ostial)

Keywords: drug eluting stents strut coverage by optic coherence tomography early endothelization